October 12th 2025
Patient: Female, 70s, hx respiratory failure; requires CPAP at bedtime per orders.
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Event: Overnight shift patient was noted without CPAP in place.
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AM assessment: Pt noted to be lethargic the following morning (behavior change compared to baseline when CPAP used overnight). Family at bedside expressed concern and were unhappy; they voiced complaint to provider. Provider contacted RN and was made aware of situation.
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Respiratory: Requires CPAP at night to maintain adequate ventilation/oxygenation. CPAP omission overnight likely contributed to decreased O₂ support and subsequent lethargy. (Moral: inadequate O₂ → decreased cognitive/functional status.)
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Action taken: Provider notified. Family updated. Staff educated/reinforced at shift change that CPAP must be applied per orders at bedtime and secured for overnight use. Continued close monitoring of respiratory status and neuro status; encourage adherence to CPAP each night. Call bell within reach; safety measures maintained.
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Plan: Reapply CPAP as ordered at next bedtime. Document compliance each shift. If lethargy persists or any respiratory decompensation occurs, notify provider/RT and consider immediate intervention (O₂/ABG/transfer as indicated). Continue to document family concerns and provider communications in chart.
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